Obama Expands Obamacare Protections For The Transgendered

[jmyrlefuller]

http://dailycallernewsfoundation.org/2015/09/03/obama-expands-obamacare-protections-for-the-transgendered/

by Blake Neff
September 3, 2015

The Department of Health and Human Services (HHS) announced a planned new regulation Thursday that will require health insurers participating in Obamacare to cover more health procedures sought by the transgendered.

The new rule applies to every health insurer offering plans through Healthcare.gov or any of the state-run Obamacare insurance exchanges. It declares that insurers are prohibited from engaging in discrimination not only on the basis of sex, but also on the basis of gender identity.

In the past, several health insurance plans have categorically excluded health care related to transitioning between genders, often on the grounds that such procedures are often cosmetic, not medically necessary, and elective in nature. Now, such categorical bans will be disallowed, and insurers will have to cover many of the procedures.

HHS says the new rule won’t require insurers to cover all hormone treatments or sex reassignment surgeries, but it will almost certainly require them to cover a large number of them.

Jocelyn Samuels, director of HHS’s Office for Civil Rights, told CNBC that the new rule would prohibit insurers from denying surgeries and other procedures simply because they’re intended to treat gender dysphoria (where a person feels their body has the wrong gender) rather than some other ailment. For example, if a doctor recommended a hysterectomy (removal of the uterus) to treat gender dysphoria in a woman who identifies as a man, the insurance company couldn’t deny it if it would ordinarily follow such a recommendation for other conditions (like cancer).

The new rule additionally requires that “Individuals must also be treated consistent with their gender identity, including [in] access to facilities.” That means, among other things, healthcare providers will have to let the transgendered use the bathrooms (and in some cases, hospital wards) of the gender they identify with, even if it clashes with their physical sex.

Human Rights Campaign (HRC), a leading gay and transgender-rights group in the U.S., lauded the new measure.

“LGBT people have too often faced healthcare and coverage systems that provide inequitable and hostile treatment on the basis of their sexual orientation or gender identity,” said HRC’s government affairs director David Stacy. “This proposed regulation will help address some of these disparities and is vitally important to help end discrimination against transgender and gender nonconforming people in healthcare and insurance.”

The new regulation also includes other provisions intended to help women, the disabled, and those who can’t speak English. For instance, insurers may be expected to provide sign language interpreters for the deaf so they can communicate better with health care providers.

The regulation is currently open for public comment, and will not be finalized for several months.

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[mountaineer]

In other O'care news:

Fourteen states may see double-digit increases on at least 40 percent of ObamaCare health products

In case you have not already heard, health insurance companies operating on the ObamaCare exchanges in several states have requested big premium increases for health plans that will be available in the 2016 open enrollment period. Insurers have cited a higher utilization of healthcare as one of the reasons for the proposed increases, which must be approved by state regulators. In short, in many instances, they are paying out more in claims than they are receiving in premiums.

A report released on Wednesday by Agile Health Insurance offers some details on the extent of the rate increases. Insurers request increases on a plan-by-plan basis with justification for the hike required. The report is based on a review of products, which, as it notes, "is a collection of plans from the same insurer" and "may contain plans with different metal levels."

Some plans may not be utilized as frequently as others, meaning plans are either profitable or premiums received keep pace with claims paid out. As a result, proposed rate increases may stay in the low to high single digits. But in ten states, insurers have asked for double-digit premium increases for at least half of the health products offered on the exchanges.

"Double-digit proposed rate hikes were the norm in several states that used the federal Obamacare exchange," Agile Health Insurance notes in the report. "All Obamacare individual products on the exchange in Delaware, South Dakota, and West Virginia had double-digit proposed rate hikes for 2016."

ObamaCare products in seven other states may see double-digit increases -- Montana (86 percent), Utah (83 percent), Louisana (75 percent), North Carolina (75 percent), Iowa (73 percent), North Dakota (67 percent), and Nevada (50 percent). Increases between 39 and 46 percent have been requested in five states, including Georgia, Virginia, and Pennsylvania. Only three states -- Arkansas, Maine, and Mississippi -- have no products with double-digit rate hikes.

One potential problem here is that consumers are automatically re-enrolled in the ObamaCare plans they selected. Though they are urged to shop to select different and, perhaps, more "affordable" plans, a recent survey conducted by Deloitte Center for Health Solutions found that 45 percent of ObamaCare enrollees switched plans. Those who did not saw premium increases of up to 20 percent.

President Barack Obama has urged the public to pressure insurance commissioners and regulators to reject big premium increase requests from insurers. Just last month, Health Insurance Marketplace CEO Kevin Counihan, who oversees HealthCare.gov, penned a letter to insurance commissioners arguing that large increases are not necessary.

Plans available for sale on the ObamaCare exchanges are required to offer certain benefits that drive up the cost of health insurance coverage. Though subsidies may diminish the cost impact to eligible consumers, taxpayers are expected to pick up the tab to the tune of $1 trillion between 2016 and 2025. Cost may still be an issue for many consumers, while others may not be thrilled about the sparse physician networks for available ObamaCare plans.

With this in mind, consider a thought recently offered by health insurance market analyst Robert Laszewski: "After all of this and two complete open enrollments, only 40% of those who are eligible for Obamacare have signed up -- far below the proportion of the market insurers have historically needed to assure a sustainable risk pool." He went on to note that "f this were a private enterprise enjoying these kinds of benefits, and only sold its product to 40% of the market, its CEO would be fired."

Those who need coverage and/or cannot afford may find what ObamaCare plans offer attractive, but those who are used to getting more out of their coverage may simply decide to pass on pricey health plans that are not amenable to their financial situations or need for coverage. The result is a thinning out of the available risk pools that, you guessed it, leads to higher insurance premiums.

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